Increases budget neutrality threshold from $20 million to $53 million
-Bill introduced House 11/2023. Forwarded to two committees. Approved House E&C Health subcommittee. Forwarded to full committee 11/2023. No interval action
-Bill introduced Senate 8/2024. Referred to Finance Committee. No interval action.
3. Streaming Prior Authorization Practices
HR 8702/S 4532 Improving Seniors’ Timely Access to Care Act of 2024
Would codify CMS Interoperability and Prior Authorization Rule 1/2024 making it permanent.
Provides mandates for electronic PA, increases insurance company transparency, reduces response times, and creates a pathway to realtime decision making for routinely approved services
-Bill introduced House 6/2024. Referred to two committees 6/2024. No interval action
-Bill introduced Senate 6/2024. Referred to Finance Committee 6/2024. No interval action
4. Maintain Critical Telehealth Flexibilities
HR 7623 Telehealth Modernization Act
Extends current telehealth visit PHE provisions for 2 years (does not make permanent)
-Bill introduced 3/2024. Passed subcommittee on Health unanimously. Full committee ordered reported amended bill to full House unanimously 9/2024. No interval House action.
HR 1406/S 3021 Sustainable Cardiopulmonary Rehabilitation Services at Home Act
Increases remote access to cardiac and pulmonary rehab for patients with mobility issues or living in rural areas
-Bill introduced in House 3/2023. Referred to two committees and appropriate subcommittees. E&C Subcommittee on Health forwarded amended bill to full committee 5/2024. No interval action.
-Bill introduced in Senate 10/2023. Referred to Finance Committee. No interval action.
5. Increase Community Access to AEDS
HR 2370/S 1024 Access to AEDs Act
Authorizes HHS grants to public elementary and high schools for AED purchases, AED and CPR training, maintenance costs.
-Bill introduced in House 3/2023. Referred to two committees. Referred to E&C Health Subcommittee 4/2023. No interval action
-Bill introduced in Senate 3/2023. Referred to committee. No interval action.
HR 6829 Cardiomyopathy Health Education, Awareness, and Research and AED Training in the Schools (Hearts) Act
Includes above Access to AEDs Act provisions plus HCM education and research funds.
-Bill passed the House 9/2024. Referred to Senate 9/2024. Referred to committee.
HR 10073 Medicare Patient Access and Practice Stabilization Act of 2024
Bill would 1) eliminate pending 2.8% cut to medicare 2025 provider payment; and 2) provide inflationary update equal to 50% of Medicare Economic Index
-Bill introduced in House 10/29/2024. Referred to two committees.
** Grassroots Action Alert from the ACC is in your inbox **- please submit email to your house representative! **
CMS Medicare Physician Fee Schedule 2025 Final rule
General highlights:
PFS conversion factor is $32.3465 = 2.83% reduction from 2024
PFS reimbursement for cardiovascular services is projected to remain overall flat c/w 2024.
Telemedicine:
Telehealth originating site location to certain rural and underserved location
Audio-only will satisfy interactive telecommunications if 1) patient cannot or will not use video technology. 2) Practitioner must still have audio-video capabilities.
Through 2025 practitioners can still use enrolled practice location instead of home address when providing telehealth services from home.
ASCVD Risk Assessment and Management G Codes:
CMS proposal to create coding and payment for CV medication, BP, and lipid management, and smoking cessation.
Quality Payment Program:
Six new MIPS Value Pathways (MVPs) to be available 2025 performance year.
Revisions to all previously finalized MVPs.
CMS Outpatient Prospective Payment System and Ambulatory Surgery Center 2025 Final Rule
General highlights:
OPPS payment increase 2.9% to hospitals and ASCs meeting quality reporting requirements
No change made to cardiovascular services on Inpt-only and ASC Covered Procedures List
Notably, cardiac ablations were not added to the ASC CPL (happy to provide more detail).
CMS temporarily reassigning some cardiac CT codes to increase payment (almost 2-fold) while claims data reviewed
CMS to separately pay for radiopharmaceuticals meeting a $630/d threshold.
State Advocacy - Update to State legislative letter 10/2024
Update from 9/2024 state legislative recap 9/2024:
VCACC policy proposal to ban noncompete clauses for healthcare providers was approved without dissent at the Medical Society of Virginia House of Delegates 10/2024
Efforts to gain support to create a bill are ongoing with MSV Government Affairs, MSV BOT, and state senate representatives.
Thank you to VCACC legislative delegation participants
